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Contact Information

MARIPOSA TRANSFORMATION WELLNESS CENTER, LLC
4550 EUBANK BLVD NE
SUITE D205
ALBUQUERQUE, NM87111-2565
 Phone: 505-234-6432
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MARIPOSA TRANSFORMATION WELLNESS CENTER, LLC

NPI # 1962127878
LBN Legal business name MARIPOSA TRANSFORMATION WELLNESS CENTER, LLC
Authorized official MICHELLE LUCERO - (PA-C / OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/04/2022
Last updated 03/30/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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